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Pumping and engorgement/oversupply

Hi,

I am new to this forum and to BF (my first baby is only 5 1/2 weeks old). I've been EBF since she was born. I make way more milk than she takes, so I'm often engorged and I even had a clogged duct at 3 weeks.

I would like to start pumping so that she can be fed from a bottle occasionally (say, if I need to go to the doctor or run an errand). Also, she has started sleeping longer stretches (4 or 5 hours) at night, and this leaves me painfully engorged. Here are my questions:

1. Can I pump during her long sleep stretch just to relieve my breasts a little bit, or will this make engorgement worse? I would be OK with pumping just a little at a time.

2. How can I pump so that I can have enough for occasional bottles, while avoiding having even more of an oversupply than I naturally have?

3. Do manual pumps work/help in these situations, or should I go straight for an electric?

I would also appreciate any extra tips and advice on this. I'm feeling a bit daunted!

Thanks!

PS. I will stay at home for her first year so I don't need to worry about pumping at work.

Re: Pumping and engorgement/oversupply

1. Can I pump during her long sleep stretch just to relieve my breasts a little bit, or will this make engorgement worse? I would be OK with pumping just a little at a time.

You can, but it will make the engorgement worse. You are getting engorged because your body is used to your baby eating @ that time, but she is asleep. I would try to just hand express enough to relieve pain, but only just enough. If you can power through, your supply will adjust downwards to meet her needs.

2. How can I pump so that I can have enough for occasional bottles, while avoiding having even more of an oversupply than I naturally have?

The key will be to not pump routinely. Pump a few times in the morning to save up a few bottles (like maybe 5). Then when you are away from your baby, you will need to pump to replace the feeding you miss; that will replace the bottle that was used.

3. Do manual pumps work/help in these situations, or should I go straight for an electric?

Manual pumps are perfect for those situations. I don't know the ins and outs of manual or single-electric pumps, b/c I work outside the home and went straight for the double-electric; I'm sure some of the other SAHMs on here can vouch for one or the other.

Have you considered trying to block feed? It can help tone down your supply a bit. What I do is feed my baby on only one side each feeding.

You know I sometimes would *rather* deal with under supply than over supply b/c oversupply can be tricky and risky business. That's b/c with oversupply the very things you want to do to tame the supply monster might put you at risk for all the complications associated with oversupply and the back up of too much milk in the breasts.

Ok but here goes. The trick is to signal your breasts to SLOW DOWN for goodness sake!!!! The way that *normally* happens is that as milk backs up in the breast the breasts get the signal to slow down on production. For some reason it seems as though in moms with oversupply the breasts aren't getting the signal or they are responding very slowly to it.

Of course any time milk is excessively backing up in the breast you are at an increased risk for mastitis, plugs, and just generally feeling over full and uncomfortable. So part of the trick is to allow milk to back up to help signal the breasts to slow down without allowing it to back up so much that you get into trouble.

Sometimes it is helpful to do more frequent feedings. It may be more comfortable for the baby because the milk let down will be less forceful. It may be more comfortable for mom b/c she is not having long stretches without any milk drainage.

Of course you have already heard to just use one breast per feeding. Let the baby tell you when she is finished, she will either come off the breast spontaneously or remain on the breast without any sucking for a long time, then you can remove the baby. If the baby needs a burp and diaper change and wants to go back to the breast to get settled again, put her back on the same breast.

Some moms find they need to use one breast per 2 or even 3 feedings in a row but work up to this gradually. You can also try one breast per block of time. For example, only the right from 8am to 10 am then only the left from 10 am to 12 noon. If that isn't enough you can increase the length of the block of time but again build up gradually. Start with 2 hour blocks and increase in 1/2 hour increments until you are at the point where it works.

When you first start using only one breast per feeding you may need to express milk from the "unused" breast, but only pump as much as you need to for comfort and reduce the amount you pump daily until you don't need to pump at all so you don't overstimulate the supply and perpetuate the problem. Some women notice the need to pump diminishes gradually without doing anything special. Others need to systematically keep records and reduce in a methodical way. For example if you notice you need to pump off 2oz from the unused breast each time try to reduce that to 1.5oz for 3-4 days and then if all is ok reduce to 1oz, etc.

Experiment with different positions to see what seems most comfortable with your baby. Some like positions that make the flow of milk work against gravity, such as a reclined position with the baby face down on mom. Others may prefer an elevated football hold (baby sitting up facing mom), some like side lying.

Some may prefer to come off or be removed from the breast when the milk lets down until the flow slows a little. Just catch the extra milk in a towel if needed.

Between feedings you can discourage blood flow and milk production by applying cool compresses to the breasts. Leave them on for 30 minutes and off for 60 minutes before reapplying. Keep repeating this procedure until you get the desired results.

You can also try cool green cabbage leaf compresses to the breasts, they are thought to reduce milk supply (no science on this one yet). Change them every 2 hours or when they wilt, whichever comes first. Apply for one day then watch for results the next day, reapply every other day until desired results are seen.

Avoid unnecessary breast stimulation, such as using breast shells (plastic domes some women use inside the bra to hold the cloth off of sore nipples)

It is also good to know that for most women the monster milk supply will come more into line with exactly what the baby needs by about 3 months or sometimes sooner b/c of hormonal changes.

Re: Pumping and engorgement/oversupply

For your situation, use a hand pump. It will save you a pile of money, isn't that time consuming for someone who might need a bottle once in a while, and it's that hard on your body. I had an Isis that I used for about five years to do exactly that. I could pump to leave milk for once in a while, and I even worked PT and pumped with it for a while. I didn't get a double electric, actually, until I had baby #3 and was pumping to provide milk for another mama.

Most moms find pumping in the morning and saving the result up easiest, but a mom with an OS might want to just pump and get a whole bottle at once...but not on a routine basis. Otherwise, you'll find yourself having to pump at X time every day because your body expects to need that much milk then.

I would not pump during the long stretch. Leaving things alone will eventually tell your body to not make that much milk then. If you pump, that supply issue will never resolve...and babies often switch things up anyway.

Re: Pumping and engorgement/oversupply

Dear Susan and Jeno,

Thanks for the thoughtful replies and detailed advice! This forum is truly wonderful. And breastfeeding can be so complicated in its own way! I just got a hand pump and I will start trying it out soon. I will also ride out the long stretches as you all suggested. After all, I will also enjoy longer sleep stretches very much!...